Who Is Affected By IBS?
Although IBS symptoms are generally similar between special populations of people, IBS may still impact men, women, and children differently. IBS is predominantly diagnosed in women. The female to male ratio of IBS prevalence is approximately 2:1. The predominance by women may be due to the presence of sex hormones.1 Studies suggest that women’s response to IBS symptoms may be due to declining or low ovarian hormones. The low levels of estrogen and progesterone may contribute either directly or indirectly to an increase in pain sensitivity. Immediately before and during their menstrual cycle, women report an increase in gastrointestinal symptoms. The gastrointestinal symptoms reported include bowel discomfort, abdominal pain or discomfort, bloating, and alterations in bowel patterns.2 Hormonal changes during pregnancy may also affect bowel function and gastrointestinal pain sensitivity. Constipation is the most common complaint reported by pregnant women.3
In a study comparing prevalence and symptoms of IBS in men and women, men reported a higher frequency of loose, mushy or watery stools within the last 3 months. Therefore, men may have a higher prevalence of diarrhea-predominant IBS. In contrast, constipation-predominant IBS was more common in females.4 More often, women reported symptoms of nausea, more severe bloating, higher symptom severity, and lower quality of life compared to men.4,5 In addition women reported more general anxiety, but there was no difference in depression between men and women.5
In addition, IBS has been associated with impairment in children and adolescents, who commonly complain of recurrent abdominal pain.6 Although children are affected by all subtypes of IBS, they more frequently have IBS with constipation.7 Not only are children directly affected by IBS, but their parents and families are indirectly affected. The affect on parents and the impact on siblings make IBS a “family disease”, much like any other potentially chronic condition. Parents feel more stress about their child’s health and may have to take time off from work to care for a child with IBS. Children with IBS may have more school absences, which may impact parents who may need to stay home from work. Children may have a lower quality of life compared to healthy children because of their daily pain, including non-gastrointestinal symptoms, such as headaches.6 Parents of children complaining of abdominal pain may also make note of some red flag symptoms, such as night time pain or diarrhea, recurrent or worsening rectal bleeding, and stools that may be difficult to flush away. These are some red flag symptoms that may suggest the need for proper diagnosis of a bowel disorder, particularly IBS.8